The benefits for the professional working within a quality culture are manifold, but even more important, the patient is the final arbiter of quality care. Therefore patient centred aspects of treatment are focused upon in this manual. A quality manual intended for European use has to respect the national regulations and European diversity, and therefore needs to be flexible. The EOQM has been structured according to the treatment of the individual patient, which is what all professionals have in common, and which also is the most important target for quality improvement in orthodontic practice. The EOQM is primarily designed as a stimulus for the orthodontic professional to assess and improve the quality of orthodontic care. A Quality Improvement System (QIS) provides support for starting and maintaining activities. The manual provides tools to systematically assess and develop quality-related actions at individual (patient) treatment level and practice level. A systematic and comprehensive description of the treatment process is essential in order to provide a basis for establishing a QIS. Implementing a QIS will influence the provision of orthodontic care by: demonstrating the potentials for development of the organizational elements of orthodontics; and planning and integrating systematic activities to monitor and improve treatment at the practical level and the patient-related level. Orthodontic treatment process is the central element in this manual. The route taken by an individual patient is described step by step: flowcharts describe the orthodontic treatment of the individual patient step by step; guidelines indicate what the professional should do at the various steps in order to follow the generally accepted objectives of orthodontics as described in the policy The EOQM provides the orthodontic professional with a model for incorporating quality improvement into daily practice, which is based on European orthodontic consensus and current principles of quality in health care. It can be incorporated in the quality initiatives that are already being developed nationally and vice versa.